Stuart Scullion stepped down as executive chairman of the Association of Medical Insurers and Intermediaries (AMII) just last month after six years at the head of the organisation.
Scullion (pictured) will continue to work as a consultant bringing to bear decades of experience both as an insurer and running a large intermediary.
Health & Protection spoke to him about the future of healthcare delivery, the rising necessity for mental health support, and the political future of the NHS and private healthcare.
H&P: It could be said that we are in a period of assessment and of taking stock in terms of the crisis. But looking forward what do you think will be the drivers of real change in health insurance?
Scullion: “The coronavirus pandemic has changed our approach to healthcare and healthcare delivery in a negative and positive way. On the plus side, every one of us who has access to a computer and the internet has embraced some form of digital healthcare delivery.
“We have embraced digital technology in a way which would have probably taken five years without the pandemic. When was the last time you had a face-to-face consultation with your GP? That is only going to accelerate. Digital healthcare is here to stay.
“But there have been huge negatives, including the practical implications for everyone forced to work from home since 23 March 2020. Many families struggled with the basic practicalities of finding space to home work let alone the implications for wider family members.
“It is even worse for those who live alone and have to endure an imposed isolation especially – in relation to the impact on their mental health. We are sociable beasts, and I doubt we had given any real consideration to not having that daily interaction with friends, family and colleagues.
“Suddenly employers had to deliver mental health support in a way they may not have previously had to consider. That has been a challenge for everyone. Virtually every health insurer has taken steps to enhance their mental health support, helping employers and employees face that new challenge.”
Insurer and intermediary propositions
H&P: How does that relate to changes in healthcare more generally? Will insurers and intermediaries be changing what they offer driven by changes such as remote healthcare?
Scullion: “Digital healthcare delivery will be one impact, but advances in medical technology will impact too. As an example, urine and saliva testing will soon have the same quality of results as the traditional blood tests.
“They will be less intrusive and can be delivered from the comfort of your own home. You could even argue they will contribute to a reduction in your carbon footprint.
“Wearable devices and mobile phone apps, delivering real time monitoring of key health indicators 24/7, will support a prevention not cure approach and see the early detection and diagnosis of medical conditions.
“Tech savvy people will expect this kind of healthcare tracking on the move. We need to remember the mobile phone is actually a personal supercomputer, more powerful than the one which put a man on the moon in 1969.
“I also predict further growth in health and reward initiatives as an integral part of the benefits and features of insurers’ products, with people encouraged to take a positive interest in their own health. I think Vitality have to take great credit for that. I must confess I originally thought it was all just a gimmick, but I don’t think that now. Exercise, weight, smoking, alcohol consumption and the quality of our sleep are all key indicators for our overall health which are more easily encouraged through interactive and result driven health and reward initiatives. These will be driven by insurers and health professionals as opposed to intermediaries in the main.”
Mental health demands
H&P: How important will mental health and wellbeing prove to be in coming years in terms of what is offered to employers and individuals?
Scullion: “I think the mental health impact of the pandemic lockdown has been far greater than anyone envisaged. Employees are asking what mental health support is being provided for them, which in many instances has caught employers ill-prepared.
“Large corporate employers already know they need to provide integrated wellbeing propositions to attract and retain their best talent. There is growing evidence of the same level of expectation in the SME sector across businesses of all shapes and sizes.
“Health insurers have identified the same needs and virtually every one of them is offering increased mental health coverage as part of benefits packages, dedicated support lines as well addressing the subject head on through online seminars and webinars. For those without internet access hard copy information is available to support them.”
Tax incentives and political visions
H&P: A lot of the debate around private sector involvement in health revolves around traditional left/right political debates. Is there a way to get beyond this and how does this relate to winning the case for reform of Insurance Premium Tax?
Scullion: “Everyone knows governments are formed by winning the hearts and minds of the political centre not pandering to the whims of the left or right of party politics. No one bats an eyelid that we have tax incentives on pension contributions for those who have the will and means to make provision for their own retirement.
“Yet, any suggestion of the same thing being endorsed in relation to healthcare is met with fear by politicians on both sides of the debate. I have long been of the opinion that the NHS and private sectors are not in competition. They need to be considered as being supportive of each other. Instead of taxing individuals, and employers taking responsibility for their own health and that of their employees, why not incentivise them and reduce the burden on the NHS?
“The coronavirus pandemic has only served to demonstrate the pressure the NHS is under with waiting lists now at 4.7 million and more than 377,000 people having waited for more than 12 months for treatment. We need to think differently. The problem will not be resolved by more of the same.”
